| NPI | 1417959636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 4753) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2016-05-13 |